[攝護腺癌] 攝護腺癌救援性放射治療是否要加上ADT(RTOG0534)

攝護腺癌(prostate cancer), 許多病人會接受手術(radical prostatectomy), 術後如果PSA升高, 此時就會做所謂的救援性放療(salvage RT), 然而salvage RT 的做法以及是否要加上ADT, 目前還是有爭論, 因此 SPPORT trial (RTOG0534) 試圖回答這個問題! 

SPPORT trial 的全名是 Short Term Androgen Deprivation Without or With Pelvic Lymph Node 

收案條件:

pT2-3 N0-x 的病人(Nx不可以是cN+), 分成三個arm, 來做比較:

arm 1: prostate bed radiotherapy only 

arm 2: prostate bed radiotherapy + short-term ADT

arm 3: prostate bed + pelvic LN RT +short-term ADT

primary endpoint: FFP(freedom from progression), 這裡的progression 是用 phoenix definition來作定義

實驗共收案1792個病人, 初始結果發表在ASTRO 2018, 實驗是利用Arm 3 比 Arm 1 以及 Arm 3 比 Arm 2, 發現FFP 都是Arm 3比較好!

reference:

1. Pollack, A., et al. "Short term androgen deprivation therapy without or with pelvic lymph node treatment added to prostate bed only salvage radiotherapy: the NRG Oncology/RTOG 0534 SPPORT trial." International Journal of Radiation Oncology• Biology• Physics 102.5 (2018): 1605.